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Frank M. Painter

About Frank M. Painter

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.
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Low Back Pain: A Major Global Problem For Which

By |June 26, 2018|Low Back Pain|

Low Back Pain: A Major Global Problem For Which the Chiropractic Profession Needs to Take More Care

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2018 (Jun 25); 26: 28

Simon D. French, Aron S. Downie and Bruce F. Walker

Department of Chiropractic,
Faculty of Science and Engineering,
Macquarie University,
Sydney, Australia

An important series of papers have been published in the Lancet. These papers provide a comprehensive update for the major global problem of low back pain, and the challenges that low back pain presents to healthcare practitioners and policy makers. Chiropractors are well placed to reduce the burden of low back pain, but not all that chiropractors do is supported by robust, contemporary evidence. This commentary summarises the Lancet articles. We also make suggestions for how the chiropractic profession should most effectively help people with low back pain by implementing practices supported by high quality evidence.

This is just one article from a series of 4:

The Lancet 2018 Series on Low Back Pain

From the Full-Text Article

Background

Low back pain is a major global problem and it is getting worse. [1] An important series of articles in the journal Lancet, authored by world leading authorities on low back pain evidence, has drawn international attention to how enormous the problem is. The Lancet authors also discussed how low back pain is being poorly managed by healthcare systems around the globe, including emerging issues in low and middle-income countries. [2–4] This commentary will summarise the main findings of these Lancet papers, and provide some suggestions for how the chiropractic profession should respond to the global challenge that is low back pain.

The Lancet papers

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Be Good, Communicate, and Collaborate: A Qualitative Analysis

By |June 24, 2018|Integrative Care|

Be Good, Communicate, and Collaborate: A Qualitative Analysis of Stakeholder Perspectives on Adding a Chiropractor to the Multidisciplinary Rehabilitation Team

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2018 (Jun 22); 26: 29

Stacie A. Salsbury, Robert D. Vining, Donna Gosselin and Christine M. Goertz

Palmer Center for Chiropractic Research,
Palmer College of Chiropractic,
Davenport, USA

Background   While chiropractors are integrating into multidisciplinary settings with increasing frequency, the perceptions of medical providers and patients toward adding chiropractors to existing healthcare teams is not well-understood. This study explored the qualities preferred in a chiropractor by key stakeholders in a neurorehabilitation setting.

Methods   This qualitative analysis was part of a multi-phase, organizational case study designed to evaluate the planned integration of a chiropractor into a multidisciplinary rehabilitation team. The setting was a 62–bed rehabilitation specialty hospital located in the northeastern United States. Participants included patients, families, community members, and professional staff of the administrative, medical, nursing, and therapy departments. Data collection consisted of audiotaped, individual interviews and profession-specific focus groups guided by a semi-structured interview schedule. Transcripts were imported into a qualitative data analysis program for data analysis. An iterative coding process using thematic content analysis categorized key themes and domains.

Results   Sixty participants were interviewed in June 2015, including 48 staff members, 6 patients, 4 family members, and 2 community members. Our analysis generated a conceptual model of The Preferred Chiropractor for Multidisciplinary Rehabilitation Settings composed of 5 domains and 13 themes. The domain, Patient-Centeredness, or the provision of healthcare that is respectful, responsive, and inclusive of the patient’s values, preferences, and needs, was mentioned in all interviews and linked to all other themes. The Professional Qualities domain highlighted clinical acumen, efficacious treatment, and being a safe practitioner. Interpersonal Qualities encouraged chiropractors to offer patients their comforting patience, familiar connections, and emotional intelligence. Interprofessional Qualities emphasized teamwork, resourcefulness, and openness to feedback as characteristics to enhance the chiropractor’s ability to work within an interdisciplinary setting. Organizational Qualities, including personality fit, institutional compliance, and mission alignment were important attributes for working in a specific healthcare organization.

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Developing Integrative Primary Healthcare Delivery

By |June 21, 2018|Integrative Care|

Developing Integrative Primary Healthcare Delivery: Adding a Chiropractor to the Team

The Chiro.Org Blog

SOURCE:   Explore (NY). 2008 (Jan); 4 (1): 18–24

Michael J. Garner, MSc, Michael Birmingham, PhD, Peter Aker, MSc, DC, David Moher, PhD,
Jeff Balon, DC, MD, Dirk Keenan, DC, and Pran Manga, PhD

Carlington Community and Health Services,
Ottawa, Ontario, Canada.

BACKGROUND:   The use of complementary and alternative medicine has been increasing in Canada despite the lack of coverage under the universal public health insurance system. Physicians and other healthcare practitioners are now being placed in multidisciplinary teams, yet little research on integration exists.

OBJECTIVE:   We sought to investigate the effect of integrating chiropractic on the attitudes of providers on two healthcare teams.

DESIGN:   A mixed methods design with both quantitative and qualitative components was used to assess the healthcare teams. Assessment occurred prior to integration, at midstudy, and at the end of the study (18 months).

SETTING:   Multidisciplinary healthcare teams at two community health centers in Ottawa, Ontario, participated in the study.

PATIENTS/PARTICIPANTS:   All physicians, nurse practitioners, and degree-trained nurses employed at two study sites were approached to take part in the study.

INTERVENTION:   A chiropractor was introduced into each of the two healthcare teams.

MAIN OUTCOME MEASURES:   A quantitative questionnaire assessed providers’ opinions, experiences with collaboration, and perceptions of chiropractic care. Focus groups were used to encourage providers to communicate their experiences and perceptions of the integration and of chiropractic.

RESULTS:   Twelve providers were followed for the full 18 months of integration. The providers expressed increased willingness to trust the chiropractors in shared care (F value = 7.18; P = .004). Questions regarding the legitimacy (F value = 12.33; P < .001) and effectiveness (F value = 11.17; P < .001) of chiropractic became increasingly positive by study end.

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Back and Neck Pain Exhibit Many Common Features in Old Age

By |June 20, 2018|Chronic Low Back Pain, Chronic Neck Pain|

Back and Neck Pain Exhibit Many Common Features in Old Age: A Population-based Study of 4,486 Danish Twins 70-102 Years of Age

The Chiro.Org Blog

SOURCE:   Spine 2004 (Mar 1); 29 (5): 576–580

Jan Hartvigsen, DC, PhD, Kaare Christensen, MD, PhD, and Henrik Frederiksen, MD, PhD

Nordic Institute of Chiropractic and Clinical Biomechanics,
Institute of Public Health,
University of Southern Denmark,
Odense C, Denmark.

STUDY DESIGN:   Cross-sectional and longitudinal analysis of data comprising 4,486 Danish twins 70-102 years of age.

OBJECTIVES:   To describe the 1-month prevalence of back pain, neck pain, and concurrent back and neck pain and the development of these over time, associations with other health problems, education, smoking, and physical, and mental functioning.

SUMMARY OF BACKGROUND DATA:   Back pain and neck pain are prevalent symptoms in the population; however, there is little research addressing these conditions in older age groups.

METHODS:   Extensive interview data on health, lifestyle, social, and educational factors were collected in a nationwide cohort-sequential study of 70+ year-old Danish twins. Data for back pain, neck pain, lifetime prevalence of a comprehensive list of diseases, education, and self-rated health were based on self-report. Physical and mental functioning were measured using validated performance tests. Data including associated factors were analyzed in a cross-sectional analysis for answers given at entry into the study, and longitudinal analysis was performed for participants in all four surveys.

RESULTS:   The overall 1-month prevalence for back pain only was 15%, for neck pain only 11%, and for concurrent back and neck pain 11%. The prevalence varied negligibly over time and between the age groups, and 63% of participants in all surveys had no episodes or only one episode of back or neck pain. Back pain and neck pain were associated with a number of other diseases and with poorer self-rated health. Back and neck pain sufferers had significantly lower scores on physical but not cognitive functioning.

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Low Back Pain Page and the:

Chronic Neck Pain Page

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Evidence-informed Management of Chronic Low Back Pain

By |June 11, 2018|Evidence-based Practice|

Evidence-informed Management of Chronic Low Back Pain with Spinal Manipulation and Mobilization

The Chiro.Org Blog

SOURCE:   Spine J. 2008 (Jan); 8 (1): 213–225

Gert Bronfort, DC, PhDa, Mitch Haas, DC, MA, Roni Evans, DC, MS, Greg Kawchuk, DC, PhD, Simon Dagenais, DC, PhD

Northwestern Health Sciences University,
2501 W 84th St,
Bloomington, MN 55431, USA.

The management of chronic low back pain (CLBP) has proven very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient. To help understand and evaluate the various commonly used nonsurgical approaches to CLBP, the North American Spine Society has sponsored this special focus issue of The Spine Journal, titled Evidence Informed Management of Chronic Low Back Pain Without Surgery.

Articles in this special focus issue were contributed by leading spine practitioners and researchers, who were invited to summarize the best available evidence for a particular intervention and encouraged to make this information accessible to nonexperts. Each of the articles contains five sections (description, theory, evidence of efficacy, harms, and summary) with common subheadings to facilitate comparison across the 24 different interventions profiled in this special focus issue, blending narrative and systematic review methodology as deemed appropriate by the authors. It is hoped that articles in this special focus issue will be informative and aid in decision making for the many stakeholders evaluating nonsurgical interventions for CLBP.

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Characteristics of Veterans Health Administration Chiropractors

By |June 10, 2018|Veterans|

Characteristics of Veterans Health Administration Chiropractors and Chiropractic Clinics

The Chiro.Org Blog

SOURCE:   J Rehabil Res Dev. 2009; 46 (8): 997–1002

Anthony J. Lisi, DC; Christine Goertz, DC, PhD; Dana J. Lawrence, DC, MMedEd; Preeti Satyanarayana, MD, MPH

Veterans Health Administration,
Office of Rehabilitation Services,
Washington, DC

Chiropractic services have been delivered on station at select Veterans Health Administration (VHA) medical facilities since late 2004. No published data describing the characteristics of VHA chiropractic physicians (chiropractors) and chiropractic clinics exist at a national level. This study was designed to examine elements of the structures of chiropractic services in VHA settings. Web-based survey methods were used to question all chiropractors in VHA facilities (N = 36). Data were obtained from 33 providers, yielding a 91.6% response rate. Most respondents were full-time VHA employees, while others were part-time employees or contractors. Differences were found in prior training, integrated practice, and academic or research experience. Of the respondents, 88% ranked low back pain as the most common patient complaint seen in practice and 79% ranked cervical pain the second most common complaint. Of the new patient consultations, 67.6% originated from primary care, 9.4% from pain management, and 6.2% from physiatry. Most respondents were similar in their reported use of diagnostic and therapeutic procedures, but their reported rates of participation in various facility activities were different. Further work is needed for researchers and policy makers to more fully understand the integration and delivery of chiropractic services in VHA settings.

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